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Disability Certificate

This document is a disability certificate issued for Shri Trusal Alpeshkumar Jadav, who has been diagnosed with Moderate Autism Spectrum Disorder and has an 80% temporary disability. The certificate is valid for two years, expiring on 29/10/2023, and includes proof of residence via an Aadhaar card. It is important to note that this certificate is solely for certifying disability and not for identification or address proof purposes.

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minalchavda06
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55 views1 page

Disability Certificate

This document is a disability certificate issued for Shri Trusal Alpeshkumar Jadav, who has been diagnosed with Moderate Autism Spectrum Disorder and has an 80% temporary disability. The certificate is valid for two years, expiring on 29/10/2023, and includes proof of residence via an Aadhaar card. It is important to note that this certificate is solely for certifying disability and not for identification or address proof purposes.

Uploaded by

minalchavda06
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Department of Empowerment of Persons with Disabilities,

Ministry of Social Justice and Empowerment, Government of India

Disability Certificate
Issuing Medical Authority, Anand, Gujarat

Certificate No.: GJ1521120110129842 Date: 29/10/2021

This is to certify that I/we have carefully examined Shri Trusal Alpeshkumar Jadav, Son of Shri Alpeshkumar, Date
of Birth 03/09/2011, Age 10, Male, Registration No. 2415/00000/1812/0847321, resident of House No. Pilodara,
Salol, Anand - 388530, Sub District Borsad, District Anand, State / UT Gujarat, whose photograph is affixed above,
and I am/we are satisfied that:

(A) He is a case of Autism Spectrum Disorder


(B) The diagnosis in his case is MODERATE AUTISM SPECTRUM DISORDER
(C) He has 80%(in figure) Eighty percent(in words) Temporary Disability in relation to his Brain as per the guidelines
(Guidelines for evaluation and assessment of Autism and procedure for certification notified by Government of India
vide 16-21/2013-DD-III dated 25/04/2016).
This certificate recommended for 2 year(s), and therefore this certificate shall be valid till 29/10/2023

The applicant has submitted the following document(s) as proof of residence:


Nature of Document(s): Aadhaar card

Signature / Thumb Impression of the Person with Disability

Signatory of notified Medical Authority Member(s)

Issuing Medical Authority, Anand, Gujarat

This Card/Certificate is meant to certify the disability of the person and is not an instrument for ID/Address Proof for any purpose.

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